Provider Demographics
NPI:1255379632
Name:MANI, SEEMA S (DC)
Entity type:Individual
Prefix:
First Name:SEEMA
Middle Name:S
Last Name:MANI
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:SEEMA
Other - Middle Name:S
Other - Last Name:PATEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:601 S 32ND AVE
Mailing Address - Street 2:
Mailing Address - City:WAUSAU
Mailing Address - State:WI
Mailing Address - Zip Code:54401-3958
Mailing Address - Country:US
Mailing Address - Phone:715-848-2526
Mailing Address - Fax:
Practice Address - Street 1:1250 EXECUTIVE PL
Practice Address - Street 2:STE 402
Practice Address - City:GENEVA
Practice Address - State:IL
Practice Address - Zip Code:60134-3807
Practice Address - Country:US
Practice Address - Phone:630-208-8244
Practice Address - Fax:630-845-9522
Is Sole Proprietor?:No
Enumeration Date:2006-06-04
Last Update Date:2009-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038-009611111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL350056552OtherRAILROAD MEDICARE
IL038-009611Medicaid
ILCK7346OtherRAILROAD MEDICARE GROUP
IL212991Medicare Oscar/Certification
ILU93339Medicare UPIN
ILK24996Medicare PIN
IL038-009611Medicaid